Intraoperative Bronchospasm in a Peroral Endoscopic Myotomy Surgery: Not So Poetic!

Abstract

Peroral endoscopic myotomies (POEM) done primarily for treating achalasia cardia patients not responding to medical therapy involve creating a submucosal tunnel, followed by a myotomy and a mucosal incision. Common intraoperative complications of such procedures include subcutaneous emphysema, pneumothorax, pneumomediastinum, pneumoperitoneum, and hemodynamic instability. This is a case of a 56-year-old 62 kg nil-comorbid female patient diagnosed with achalasia cardia who was taken up for a POEM under general anesthesia. She developed an episode of bronchospasm postinsufflation of the abdomen with carbon dioxide.